Are there any restrictions or limitations on the use of managed care programs to obtain prescription drugs?
Yes, there are restrictions and limitations on the use of managed care programs to obtain prescription drugs in California. These restrictions and limitations vary between managed care programs and drug plans and may include restrictions on the quantity of drugs covered or the types of drugs covered. For example, some managed care plans may impose restrictions on the quantity of a particular drug that can be refilled in a certain period of time, or may require that certain drugs must be obtained from specific pharmacies or from a mail order service. Additionally, some managed care plans may limit coverage for certain drugs to only a generic version of the drug, or to certain brands. Patients should check with the specific managed care plan they are enrolled in to understand the rules relating to the quantity, type and brands of drugs covered. In addition, the patient should confirm with the pharmacy that the medications they are requesting are in fact covered under their plan. Finally, patients should be aware that there may also be geographic limitations to the use of managed care programs. Some managed care plans are not accepted in certain states, and some are only accepted in certain counties. Patients should check with their managed care plan to make sure that their medications are covered in the areas they live or travel to.
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